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Absence de corrélation entre inégalité de longueur modérée des membres inférieurs et maladie dégénérative du rachis, de la hanche, du genou : étude cadavérique

Authors :
Daniel R. Cooperman
Jonathan J. Streit
Jeremy D. Shaw
Raymond W. Liu
Elyse LeeVan
Douglas S. Weinberg
Source :
Revue de Chirurgie Orthopédique et Traumatologique. 104:440
Publication Year :
2018
Publisher :
Elsevier BV, 2018.

Abstract

Background Although asymptomatic mild limb length discrepancy (LLD) in children is generally treated non-operatively, there is limited high quality follow up data to support this recommendation. Hypothesis We hypothesized that there would be no association between LLD and arthritic changes with mild limb length discrepancy. Materials and methods We studied 576 well-preserved cadaveric skeletons ranging from 40 to 79 years of age. Limb length discrepancy was based on combined femoral and tibial lengths measured using digital calipers. Degenerative disease was hand graded in the spine, hips and knees using a previously described classification system. Power was set at 90%. Results Average age was 56 ± 10 years, and average LLD was 4.8 ± 4.0 mm. Multiple regression analysis did not demonstrate any correlation between LLD and degenerative disease. After screening to find 26 additional specimens with LLD 10 mm or greater, and assessing a potentially quadratic relationship, we still did not find any detrimental effects of LLD. Discussion Our data support the general clinical recommendation of observation for mild asymptomatic LLD. These results do not apply to larger LLD nor LLD associated with other deformities or clinical symptoms. Level of evidence Not applicable, anatomic basic science study.

Details

ISSN :
18770517
Volume :
104
Database :
OpenAIRE
Journal :
Revue de Chirurgie Orthopédique et Traumatologique
Accession number :
edsair.doi...........6809647cdf3316fa0813c95908809f6c
Full Text :
https://doi.org/10.1016/j.rcot.2018.04.019